• Journal of Gastric Cancer
• /
• v.13 no.4
• /
• pp.263-265
• /
• 2013

Intussusception is a rare cause of postoperative intestinal obstruction in adults. Many retrograde intussusceptions occur during the period following gastrectomy. A 77-year-old woman visited our hospital because of detected gastric adenocarcinoma. She received radical total gastrectomy with Roux-en-Y esophagojejunostomy. On the fifth postoperative day, she complained of abdominal pain, and we found leakage at the esophagojejunostomy site and dilatation of the Roux limb and the afferent limb of the jejunojejunostomy. Emergency surgery was performed. Retrograde jejunojejunal intussusception accompanied with a nasojejunal feeding tube was found at the efferent loop of the jejunojejunostomy. No ischemic change was found; therefore, manual reduction and primary repair of esophagojejunostomy was performed. She was discharged without complications on the 23rd re-postoperativeday. We suggest that the nasojejunal feeding tube acted as a trigger of intussusception because there was no definitive small bowel mass or postoperative adhesion. We present our findings here along with a brief review of the literature.

• Journal of Chest Surgery
• /
• v.24 no.11
• /
• pp.1090-1097
• /
• 1991

Between January 1981 and January 1991, 554 patients underwent prosthetic valve replacement. A bioprosthetic valve was replaced in 238 cases and mechanical valve 316 cases. Thirty-eight patients underwent 40 reoperations for repair or replacement, an average of 53.6 months after initial implantation. There were 21 women and 19 men, aged 12 to 60 years[mean 35.3]. A bioprosthetic valve was implanted in 31 cases and a mechanical valve in 9 cases for initial operation. Indications for reoperation were primary tissue failure in 23 cases[57.5%], endocarditis in 9[22.5%], periprosthetic leak in 4[10%]. and valve thrombosis in 4[10%]. Operations performed included 5 aortic valve replacements, 26 mitral valve replacement, 8 double valve replacements, and 1 thrombectomy. A mechanical valve was replaced in 33 cases[84.6%] and a bioprosthesis in 6[15.4Zo] for reoperation. A second reoperation was required in 2 patients. Surgical mortality was 10% . Among the 34 early survivors followed-up for an average of 19.8 months. there was 1 late death and 3 were lost to follow-up. Among the 30 late survivors being followed up, 28[93.3%] remained in New York Heart Association Class I or II and two in Class III [6.7%].

• Journal of Chest Surgery
• /
• v.49 no.4
• /
• pp.306-308
• /
• 2016

Diaphragmatic hernia was found in a patient who had undergone transhiatal esophagectomy for early esophageal cancer. Chest X-ray was not helpful, but abdominal or chest computed tomography was useful for accurate diagnosis. Primary repair through thoracotomy was performed and was found to be feasible and effective. However, long-term follow-up is required because hernia recurrence is common.

• Journal of Trauma and Injury
• /
• v.27 no.4
• /
• pp.196-200
• /
• 2014

Budd-Chiari syndrome is an uncommon condition characterized by hepatic outflow obstruction. Direct suture of the injured Inferior vena cava in a patient with blunt hepatic trauma also may cause an equivalent condition. However, early diagnosis is possible with common symptoms and radiologic evaluation. Moreover, a transluminal approach with balloon angioplasty could prevent long-term complications of Budd-Chiari syndrome without repeated abdominal surgery.

• Neurospine
• /
• v.15 no.4
• /
• pp.394-399
• /
• 2018

Subarachnoid pleural fistula (SPF) is an aberrant communication between the pleural cavity and subarachnoid space, resulting in uncontrolled cerebrospinal fluid drainage. The negative pressure of the pleural cavity creates a continuous suctioning effect, thereby impeding the spontaneous closure of these fistulas. Dural tears or punctures in cardiothoracic procedures, spinal operations, and trauma are known to cause such abnormal communications. Failure to recognize this entity may result in sudden neurological or respiratory complications. Hence, a high index of suspicion is required for early diagnosis and prompt management. Noninvasive positive pressure ventilation has been described to be effective in managing such fistulas, thus mitigating the high morbidity associated with exploratory surgery for primary repair. Herein, we describe the typical presentation of SPF and the clinical course, treatment, and follow-up of a patient who sustained SPF following anterior thoracic spinal surgery.

• Journal of Trauma and Injury
• /
• v.36 no.3
• /
• pp.276-280
• /
• 2023

Fungal thrombophlebitis of the central vein is a rare, life-threatening disease associated with significant morbidity and mortality. It requires immediate central venous catheter removal and intravenous antifungal therapy, combined in some cases with either anticoagulation or aggressive surgical debridement. A 70-year-old male patient injured by a falling object weighing 1,000 kg was transferred to our hospital. A contained rupture of the abdominal aorta with retroperitoneal hematoma was treated with primary aortic repair, and a small bowel perforation with mesenteric laceration was treated with resection and anastomosis. After a computed tomography scan, the patient was diagnosed with thrombophlebitis of the left internal jugular vein and brachiocephalic vein. Despite antifungal treatment, fever and candidemia persisted. Therefore, emergency debridement and thrombectomy were performed. After the operation, the patient was treated with an oral antifungal agent and direct oral anticoagulants. During a 1-year follow-up, no signs of candidemia relapse were observed. There is no optimal timing of surgical treatment for relapsed fungal central thrombophlebitis. Surgical treatment should be considered for early recovery.

• Tuberculosis and Respiratory Diseases
• /
• v.41 no.5
• /
• pp.574-578
• /
• 1994

The incidence of traumatic rupture of the tracheobronchial tree has been increased considerably with advent of widespread mechanization and high speed era. Rupture of the bronchus is an unusual result of nonpenetrating trauma to chest. Early diagnosis and primary repair not only restore normal lung function but also avoid difficulties and complications associated with delayed diagnosis and repair. These complications are pneumonia, atelectasis and lung abscess secondary to the bronchial obtruction. We experienced a case of partial rupture on left main bronchus caused by nonpenetrating blunt chest trauma with rib fractures 1 year ago. He was suffered from progressively developing dyspnea on exercise and treated as bronchial asthma at other hospital. Bronchoscopic finding was the narrowed lumen of left main bronchus at 1cm from carina by web-like membrane. We confirmed by bronchogram and repaired by end to end anastomosis, which is rare delayed finding in bronchial rupture without pulmonary complications. We report a case of nonpenetrating traumatic bronchial rupture, manifested by bronchial web in bronchoscopy.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.13 no.1
• /
• pp.9-15
• /
• 1991

The cleft alveolus occurs about 75% of cleft lip and palate patients. The purpose of bone grafting is improve the maxillary growth, rehabilitation of continuty of maxillary arch and providing bone for periodontal support for unerupted teeth. The bone grafting for alveolar cleft defect repair are classsified; primary bone grafting, early secondary bone grafting secondary bone grafting and late secondary bone grafting. In this article, we reported the cases of PMCB grafts for repair of the alveolar clefts showed potential benifit to the patient to induce a normal maxillary growth and providing bone foor periodontal support of unerupted teeth.

• Advances in pediatric surgery
• /
• v.19 no.1
• /
• pp.32-38
• /
• 2013

The purpose of this study is to analyze the early experience of the laparoscopic adhesiolysis for the intestinal obstruction due to postoperative adhesion. Seven patients were included in this study. The median age of those patients was 13, and there were 3 males and 4 females. Previous diagnosis and surgical procedure were various in seven cases, including small bowel resection with tapering enteroplasty, Boix-Ochoa fundoplication, Ladd's procedure with appendectomy, mesenteric tumor resection with small bowel anastomosis, ileocecal resection and anastomosis, primary gastric repair, and both high ligation. A successful laparoscopic adhesiolysis was performed in one who had high ligation for inguinal hernia and had a single band adhesion. Six out of 7 (86%) cases needed to convert open surgery due to multiple and dense type of adhesion. In conclusion, laparoscopic approach with postoperative small bowel adhesion seems safe. However, it might be prudently considered because of high rates of conversion in children.

• Journal of Chest Surgery
• /
• v.30 no.7
• /
• pp.641-646
• /
• 1997

Understanding of the surgical anatomy of patients with double outlet right ventricle (DORV) is important in the planning of biventricular repair From May 1995 to September 1996, 7 patients underwent biventricular repair for DORV with remote ventricular septal defect. There were 5 males and 2 (tamales. Age at operation varied from 2 to 9 years(mean 3.4$\pm$ 2.7years). Preoperative diagnostic assessment was made by two-dimensional echocardiography and cardiac catheterization. Ventricular septal defect was perimembranous inlet type in all patients. Associated cardiac anomalies were pulmonary atresia in two, pulmonary stenosis in five and tricuspid chordal attachment to zonal septum in five. The operations were performed intraventricular repair and pulmonary enlargement in two, REV operation in two, and Rastelli operation in three. There was no early postoperative deaths and complications. The follow-up period war from 1 month to 18mon1hs, averaging 10: 6.1 months. In the past, we considered the Fontal operation indicative as primary choice when DORV was associated with abnormal tricuspid chordal attachment to the zonal septum, but now we believe that biventricular repair is feasible for those cases by making conal flap or reattachment method. Biventricular repair has theoretic advantages because it estabilishes normal anatomy and physiology, and it was concluded that the precise preoperative evaluation using both echocardiography and cardiac catheterization was essential to the successful surgery.